Queen’s speech: what the Tories’ overhauled priorities may look like

Party’s manifesto plans will change in wake of election, with possible shifts in stance on Brexit, grammar schools and social care

The first Queen’s speech of the new parliament will be nothing like as ambitious as Theresa May had hoped, given the Conservative party’s lack of an overall majority and the need to rely on the Democratic Unionist party of Northern Ireland to pass legislation. Only a handful of key policies are likely to survive:

Related: Tom Watson asks May: did Murdoch request Gove’s return to cabinet?

Related: Q&A: how will the UK election result affect Brexit talks?

Related: Can party politics be set aside to save social care? | Paul Burstow

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Fund social care through tax – anything else punishes those who need it | Jane Young

The Tories betray wilful ignorance in refusing to acknowledge that some adults need support all their lives – asking them to pay care costs is wrong

Much has been said about the Conservative manifesto pledges on social care and Theresa May’s subsequent U-turn, but one issue that has so far escaped scrutiny is the Tories’ strange assumption that social care is all about older people. This is despite the fact that around a third of those who need social care services are of working age [pdf].

Social care affects all adults who need support because of a disability or long-term health condition. This might include a learning disability, a physical disability or severe and enduring mental ill-health. The failure of the Conservative manifesto to acknowledge any of this gives the impression of a party that is wilfully ignorant of the nature of adult social care and its beneficiaries.

Related: The ‘dementia tax’ mess shows how little May thinks of disabled people | Frances Ryan

Related: Forget money – we need to rethink what social care should look like

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The Tories would oversee the rundown of A&E and maternity units | Denis Campbell

Guardian experts give their view on the main parties’ public service manifesto pledges. Here, our health editor looks at what’s in store for the NHS

David Brindle on social care
Patrick Butler on social security
Dawn Foster on housing
Frances Ryan on disability
Anna Bawden on local government
Alan Travis on home affairs
Jane Dudman on the civil service
Damian Carrington on the environment
Scotland, Wales and Northern Ireland

The NHS in England would receive “the resources it needs – a minimum of £8bn in real terms over the next five years, delivering an increase in real funding per head of the population for every year of the parliament”. A further £10bn is pledged in capital spending. It would ensure that the NHS and social care system had all the health professionals “it needs” and it would train more homegrown medics. Backing the NHS’s Five Year Forward View and local sustainability and transformation plans (STPs) would lead to the controversial rundown of A&E and maternity units and changes to the roles of many hospitals. Any “necessary legislative changes” would be made to finally give STPs legal status. In addition, it would “review the operation of the internal market and make non-legislative changes to remove barriers to the integration of care”. GPs would provide seven-day access everywhere by 2019.

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General election: May falters during challenge over record on public services

PM confronted by nurse over issue of low pay in Question Time special, while Jeremy Corbyn is questioned over Trident and national security

Theresa May came under sustained pressure over the Conservative party’s record on public sector pay, mental health services and social care in a combative election edition of BBC1’s Question Time broadcast less than a week before polling day.

The prime minister faced a string of awkward questions from members of the public, including a challenge from a nurse, Victoria Davey, who left May faltering after confronting her over the 1% pay increase received by NHS staff.

Related: Question Time leaders’ special: May under fire over NHS and education – live

Related: The Guardian view on the election: it’s Labour

Related: Question Time leaders’ special: panel verdict

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Age shall not weary them nor must we let cares condemn them | Letters

Older people deserve respect and relief from the pressures and fears of declining physical and mental powers, say our readers

I have great respect for Simon Jenkins – he often cuts through the codswallop that often poses as journalism today. Unfortunately, he falls into the trap of Conservative thinking on social care (We all want to live longer, but someone must pay, 1 June). It does seem reasonable that those who have built up assets in their lifetimes should fund their own social care in old age, but this misses the whole point of a progressive system of taxation. Illness, frailty, misfortune can happen to anyone, rich or poor. It’s true the better off tend to live longer, with better health, but that does not mean that individuals cannot be struck down with early-onset dementia, or another devastating condition. Why should those families suffer more than other families whose progenitors were fortunate enough to enjoy perfect health? Progressive taxation, either on wealth or on income, spreads the risk and ensures that the rich and not-quite-so-rich pay their fair share towards the collective health of the nation. An inheritance tax too, properly graduated, should be part of the taxation mix, funding excellent state care for wealthy and poor alike, whatever their individual circumstances.
Hazel Davies
Newton-le-Willows, Merseyside

• Simon Jenkins is right, someone has to pay. But the need for care is a lottery and it falls unfairly on the 10% of those families whose relatives develop dementia, sometimes before they are even considered old. My relative developed Lewy body dementia at the age of 58. If he’d had cancer, he would have been cared for, but his family had to contribute to his nursing home care – after 12 years of his wife providing 24-hour care for free, with a devastating effect on her own life and freedom. Jenkins’s reference to past family situations belies the fact that women were the carers and they are now expected to work outside the home. The amount needed to provide care nationally is not so great in a rich country that we can’t all contribute to care for the sick and vulnerable, whatever their family wealth, just as we do for sick children.
Moira Sykes
Manchester

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Thinking of a career in therapy? Here are your options

Understanding the difference between counsellor, psychotherapist or psychologist can be confusing. Here’s our guide to training as a therapist

The route towards a career in counselling or therapy is baffling. When I began my journey eight years ago, I was struck by the jargon and lack of clear, streamlined advice: would I need a PhD, masters or diploma? Should I specialise or generalise? Work with adults or children, individuals or groups, families or couples? Pursue humanistic, psychoanalytic or cognitive behavioural training?

I couldn’t even comprehend the difference between a counsellor, psychotherapist and psychologist, let alone the difference between a psychoanalyst and a psychoanalytic psychotherapist.

Related: ‘I feel privileged if someone says I trust you’: working with domestic abuse survivors

The courses are also intense and emotionally triggering, which is important to know before undergoing training

Related: Mental health workers struggle with stigma about their own issues

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‘Nothing has changed!’: May as she announces social care U-turn – video

The prime minister claims nothing has changed after giving a speech that rowed back on the Conservative manifesto plan for social care, introducing the idea of a cap on costs

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Five priorities for improving children’s mental health | Paul Burstow

The mental wealth of the nation is critical to our future – young people’s mental wellbeing should be paramount

The mental health of the nation is built on foundations laid in the early years of our lives. Yet our mental health system is designed and funded to pay the price of our failure to act on the evidence and invest in the right family support in those childhood years.

We go through many life changes and transitions in our childhood and teenage years. It’s why the age of 18 is the wrong time for child and adolescent mental health services (Camhs) to “hand over” to adult services. A joint report by the health and education select committees has turned the spotlight on the role schools can play.

Related: We’re working with children in care to improve mental health | Tony Hunter

Related: Mental health services won’t help children in temporary care settings

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A supportive, loving community can help heal neglected children | Emma Colyer

Research suggests children exposed to neglect or abuse suffer poor health as adults and die sooner. We need to address the causes, not treat the symptoms

Our childhood stays with us throughout our lives. We know this intuitively, from the shiver that can accompany memories of an upsetting event from our early years even into adulthood. But it is also true in a much deeper way.

The Adverse Childhood Experience (Ace) study, carried out in the US in the 1990s, found that children exposed to serious neglect, abuse or household dysfunction were at significantly greater risk of a litany of poor health and social outcomes, ranging from heart disease, liver disease and sexually transmitted diseases to depression, suicide attempts and intimate partner violence. Most starkly, people with a high score on the Ace scale died on average nearly 20 years earlier [pdf] than their counterparts who reported no childhood adversity.

Related: Why secure early bonding is essential for babies

If the right questions are not being asked, we cannot expect to find the right answers

Related: How childhood stress can knock 20 years off your life

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Six innovations that could build a new social care system

Small community organisations and social enterprises could form an efficient, cost-effective support system for adults

An unexpected effect of cuts to council budgets, and the ensuing crisis in support services for adults and older people, is that the public is starting to understand for the first time what social care for adults actually is. The challenge now is for us to imagine what it could be.

In March, the government announced a green paper in response to the overwhelming evidence that the way we support older and disabled people is neither working nor affordable. Fewer people are getting support, care providers are leaving the sector and handing back contracts to councils, and hospitals are filling up with older people who have no medical reason to be there.

Related: Social care green paper is an opportunity too important to be missed | Peter Beresford

Related: How we can start a social care revolution in seven easy steps | Katie Johnston

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‘I was dehumanised’: Lemn Sissay on hearing his harrowing abuse report live on stage

In a blistering one-off show, poet Lemn Sissay heard – for the first time – the record of his suffering as a child in care. He explains why the theatre was the safest place to relive his beatings and betrayal

I have never been in a theatre audience like this one – so loving, supportive, involved. Then again, there has probably never been a production quite like this. It is the ultimate verbatim theatre. What’s more, part of the verbatim is happening live, unscripted, in front of us.

Lemn Sissay’s The Report, at the Royal Court in London, is just that: the reading of – and his reaction to – the psychologist’s report about the abuse he suffered over 18 years as a child in the care system. It is a one-off production. This is, by turns, theatre as shock treatment, theatre as therapy, theatre as protest and, perhaps ultimately, theatre as survival. We come away with a microscopically detailed portrait of the poet – and the system that did its best to destroy him.
Sissay, now 49, was born to an Ethiopian mother in Wigan. She was a young woman – a girl really – who had come to study in Britain and found herself pregnant. She was placed in a mother and baby unit and, at two months old, Sissay was put in care. His mother was asked to sign adoption papers and refused – she wanted her son back when she could manage better. Social services ignored her wishes, telling his long-term foster parents to treat this as adoption. Sissay was renamed Norman by his social worker, who happened to be called Norman.

Related: Lemn Sissay: ‘I would die if I didn’t live in the present’

At the end, everyone cheers. You sense they would rather just hug Sissay

Open all doors.
Open all senses.
Open all defences.
Ask, what were these closed for?

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Schools cutting mental health services to plug funding gaps, warn MPs

Services to support children’s wellbeing are ‘first thing to go’ when budgets are under pressure, parliamentary inquiry hears

Cash-strapped schools are cutting mental health services such as counsellors and pastoral provision as they try to cover funding gaps, two influential groups of MPs have said.

The health and education select committees joined forces for the inquiry, which called on the government to look at the impact of budget cuts on mental health services for children.

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We’re working with children in care to improve mental health | Tony Hunter

More than 70% of children in care have mental health problems; an expert panel is drawing up an action plan

It’s good news that mental health in general, and children’s mental health in particular, is being given increasing attention by the media and greater consideration by policymakers. Yet the mental health and wellbeing of children in care is too often marginalised in these debates. More than 70% of children in care have been diagnosed with mental health problems. Perhaps you just assume that it goes with the territory and there’s not much that can be done about it. This is absolutely not the case.

The Social Care Institute for Excellence (Scie) has started a new project, commissioned by the departments of health and education, to ensure that children in care have access to high-quality services, based on a clear assessment of need, from a range of professionals working across different agencies. The project is likely to suggest significant changes to the way assessments are conducted for children in care, which could have a big impact on up to 70,000 care-experienced children and young people.

Related: Mental health services won’t help children in temporary care settings

Related: Children’s mental health in crisis – readers share their stories

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Social care reviewer condemns UK system and calls for new tax

Andrew Dilnot says current adult social care system is ‘most pernicious means-test’ in the British welfare state

Andrew Dilnot, who carried out the government review into the funding for care and support in England, has condemned Britain’s social care system as “the most pernicious means-test in the whole of the British welfare state” and called for a new tax to fund adult social care for everyone who needs it.

The chair of the Dilnot commission on funding of care and support said a tax was needed to provide lifelong adult social care that was not means-tested.

Related: ‘We all like to feel special’: hairdressers style a revolution in care homes

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Mental health workers struggle with stigma about their own issues

Cuts and stretched services are affecting the mental health of carers in the sector, with many too ashamed to seek help

Understanding around mental health is improving: campaigns such as Time To Change have drawn public awareness to the issue and employers are realising the affects of dedicated wellbeing support to staff – which have led to a 30% reduction in mental health-related absences. But surprisingly, stigma still exists for those working in mental healthcare themselves.

Many people working in the sector are reluctant to talk about their own experiences, says Elizabeth Cotton, an academic at Middlesex University researching the topic. She was one of them. “I walked a thin line between being a competent professional and feeling like a fraud at managing my own mental health at work.”

Related: ‘I work full-time yet can’t afford to meet my basic needs’: care workers speak out

I still think every day about the patients I worked with and how the system is failing them

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